Relationship Between Sarcopenia and Both Physical Activity and Lifestyle in Patients With Chronic Liver Disease

Abstract

BackgroundSarcopenia can affect the prognosis of patients with cirrhosis or hepatocellular carcinoma. Exercise therapy and nutritional therapy are carried out to prevent processing sarcopenia. In addition, changing lifestyle is also important. However, there are only few reports on the physical activities (PAs) and lifestyle of chronic liver disease patients and their association with sarcopenia. The aim of this study is to examine the relationship between sarcopenia in patients with chronic liver disease and both PA and lifestyle.MethodsA total of 214 out-patients with chronic liver disease were enrolled into the present study. All patients were evaluated for with or without sarcopenia based on the sarcopenia diagnostic criteria of the Japan Society of Hepatology. Then, patient’s characteristics and laboratory parameters were divided into two groups with or without sarcopenia and compared. In continuous variable with significant difference in univariate analysis, cut-off value was calculated by receiver operating characteristic curve. We determined which factors were associated with sarcopenia in univariate analyses, and variables significant in the univariate analyses were entered in a multivariable logistic regression model.ResultsPatients with chronic liver disease had a prevalence of sarcopenia of 12.6% in this study. Sarcopenia patients were older (76.48 ± 6.69 versus 66.97 ± 11.19 years old; P < 0.01), had lower body mass index (BMI) (20.84 ± 2.44 versus 23.76 ± 3.72 kg/m2; P < 0.01), lower PA (6.6 (2.34 - 19.90) versus 16.5 (6.60 - 41.23) metabolic equivalents (METs)-h/week; P < 0.01) and longer total time sitting and lying on the day (7.43 ± 4.09 versus 5.68 ± 3.17 h/day; P = 0.01); retirement status (81.5% versus 48.1%; P < 0.01) and low frequency of driving (40% versus 20%; P = 0.01) were higher in sarcopenia patients than in non-sarcopenia patients. The independent predictive factors of sarcopenia, analyzed with logistic regression, were age (odds ratio (OR): 5.89, 95% confidence interval (CI): 2.15 - 16.20; P < 0.01), BMI (OR: 4.77, 95% CI: 1.87 - 12.10; P < 0.01) and PA (OR: 3.65, 95% CI: 2.15 - 16.20; P < 0.01).ConclusionSarcopenia patients’ lifestyle characteristics were longer sedentary time and low frequency of driving, high retirement. Independent predictive factors of sarcopenia were elderly, low BMI and low PA. For these patients, intervention in the lifestyle for prevention of sarcopenia may be effective for patients with chronic liver disease.

Review article: malnutrition/sarcopenia and frailty in patients with cirrhosis

“…HE is more frequent in sarcopenic than nonsarcopenic cirrhotic patients . Physical activity and quality of life are likely to be impaired in patients with malnutrition/sarcopenia due to reduced muscle mass and contractile function . Sarcopenia may also impair diaphragmatic work due to reduced muscle mass and this event may facilitate pulmonary complications especially in the context of surgery .…”

“…78 Physical activity and quality of life are likely to be impaired in patients with malnutrition/sarcopenia due to reduced muscle mass and contractile function. 79,80 Sarcopenia may also impair diaphragmatic work due to reduced muscle mass and this event may facilitate pulmonary complications especially in the context of surgery. 69 In patients with HCC, sarcopenia is an independent prognostic factor of TA B L E 3 Potential therapeutic strategies for malnourished/sarcopenia patients with cirrhosis decreasing survival, and increasing treatment-related complications and mortality.…”

Grip Strength: A Useful Marker for Composite Hepatic Events in Patients with Chronic Liver Diseases

“…Sarcopenia, as defined by decreased muscle strength and a muscle mass decline, is a common syndrome in patients with chronic liver diseases (CLDs) due to the disease burden itself (i.e., secondary sarcopenia) [3][4][5][6]. Physical activity and quality of life (QOL) are also likely to be impaired in CLD patients with sarcopenia due to skeletal muscle mass loss and muscle contractile dysfunction [7,8]. Lifestyle and physical health in early life can be long-term determinants of a muscle strength decline [9].…”

Low Serum Branched-chain Amino Acid and Insulin-Like Growth Factor-1 Levels Are Associated with Sarcopenia and Slow Gait Speed in Patients with Liver Cirrhosis

“…Sarcopenia, defined as a loss of skeletal muscle mass and strength, is associated with health-related quality of life, physical disability, and high mortality. Sarcopenia has now become the focus of attention in patients with liver cirrhosis (LC) [ 1 , 2 , 3 ]. Given that the liver plays a vital role in protein, glucose, lipid, and energy metabolism, LC is frequently complicated by protein–energy malnutrition (PEM), which can lead to sarcopenia [ 1 ].…”